COVID-19 Blog - 05/22/20
/May 22, 2020
As of May 21, 2020, there are over 5 million people diagnosed with COVID-19 and nearly 320,000 deaths worldwide. In the US, there are nearly 1.6 million infections and almost 94,000 deaths. The good news is that the number of new infections and deaths have plateaued or declining slightly, but there are still consistently over 20,000 new cases and 1,000 deaths in the US daily.
A new report from the Kaiser Family Foundation showed that in 18 states, a majority of COVID-19 deaths came from residents of long-term care facilities. A large meta-analysis of more than 11,000 COVID patients showed that smoking cigarettes doubled the risk of disease progression.
More data are coming out that emphasize that the burden of COVID-19 is disproportionately on minority communities. In California, there is evidence that African Americans and Latinx age 18-49 are dying from COVID-19 at a rate 2.5 times that of their white counterparts. More than 20,000 African Americans have died from COVID-19, for a mortality rate of 50 per 100,000 people. This means that 1 out of every 2000 African Americans have died from this disease in the last 3 months, a staggering number. The comparable mortality rate for Latinx is 22.9, Asian 22.7, and whites are 20.7 per 100,000.
The Navajo Nation in Arizona, New Mexico, and Utah now has the highest infection rate, higher than that of the state of New York. Pacific Islanders also have disparities in deaths. The Asian American Research Center on Health published a recent research brief that showed a possible mortality disparity among Asian Americans in San Francisco. There is a website that addresses common COVID-19 myths in English, Spanish, and 5 Asian languages: www.covid19factcheck.com/
In the largest study examining COVID-19 outcomes to date, medical records of 17.4 million adults in the United Kingdom were analyzed to assess for factors associated with death from COVID-19. There were 5,683 COVID-19 hospital deaths. As in previous studies, death was associated with being male, older, and having uncontrolled diabetes. Severe asthma and poverty level were also risk factors for dying from COVID-19. Blacks and Asians were also at higher risk of death compared to white Britons.
The U.S. Congress House Ways and Means committee is holding a virtual hearing on the disproportionate impact of COVID-19 on communities of color on 5/27. Organizations can submit letters about this.
One piece of good news is a study from New York that found almost everyone who had a documented COVID-19 infection upon recovery developed antibodies to it. However, it is not clear if the antibodies are protective from future infections.
On the testing front, a group of infectious disease specialists report that COVID-19 testing is quite disorganized and need coordination at the national level. These ID specialists recommend that testing should be done for patients with symptoms, for disease surveillance and contact tracing, and for monitoring frontline workers like emergency responders and healthcare workers who may have been exposed. People without symptoms in high-risk areas such as long-term care facilities could be tested. They recommend against universal testing of everyone in hospitals, schools, or widespread community-based testing, or doing antibody tests to determine if someone can go back to work.
The big news on the treatment front is a report from the Lancet today that chloroquine and hydroxychloroquine is harmful. The researchers looked at 96,032 COVID patients from 671 hospitals in 6 continents. The bottom line was that patients on chloroquine alone or with another medication, hydroxychloroquine alone or with another medication all were more likely to die in the hospital than those who did not. This is the biggest but not the only study that shows harm. My recommendation is that no one with COVID should be on these medications.
There are currently 8 potential COVID vaccines in development or being tested. One vaccine manufacturer reported that in phase I trials with humans, its vaccine generated antibodies in some patients. However, because this went out as a corporate press release and not as a research report, we are unable to assess what this means.
I will finish this update with a concern about the quality of the data we are getting from government agencies. The state of Florida fired one of its COVID-19 data scientists. According to the state, the reason was being disruptive and insubordination. According to the scientist, it was because the data and the way she was presenting it did not fit with the governor’s narrative that it was fine to re-open. Perhaps not coincidentally, the number of new COVID cases in Florida on 5/21 was the highest it has been for 30 days.
Several states including Texas, Virginia, and Vermont admitted that they were combining the number of tests done for diagnosis using the nasal swab/PCR and the antibody test done to document recovery using blood. This seems to me to be an attempt to inflate the number of COVID tests being done.
It is already hard enough to collect, report, and analyze data on the pandemic that is timely and helpful for people and policymakers to plan. If the data were being deliberately distorted, that makes it almost impossible. We need to continue to ask for better data and data transparency.